Executive – Healthcare TPA & Billing

Job Description

CIMS Hospital is hiring an Executive – Healthcare TPA & Billing to manage insurance claims, billing operations, and third-party administrator (TPA) coordination. The role involves ensuring timely claim processing, maintaining billing accuracy, and providing excellent support to patients and insurance partners. The ideal candidate should have strong knowledge of hospital billing procedures and medical insurance policies. Excellent communication and analytical skills are essential for success.

Key Responsibilities
Process patient billing accurately for inpatient and outpatient services.
Coordinate with insurance companies and TPAs for claim approvals.
Verify insurance eligibility and policy coverage details.
Prepare and submit reimbursement claims within specified timelines.
Resolve billing discrepancies and insurance claim issues efficiently.
Maintain billing records and financial documentation.
Assist patients in understanding billing and insurance procedures.
Ensure compliance with hospital billing policies and regulatory requirements.